Why Are So Many Young People Developing Uremia?

Here is a counterintuitive conclusion: uremia is not “coming after” young people—young people are actively wearing out their own kidneys.

If you stayed up late less often, drank fewer sugary milk teas, and paid a little more attention to your medical checkup results, this disease might never affect you.

More importantly, if a young person had developed this condition in China 20 years ago, they would most likely have had little choice but to wait for death. Today, however, China’s national medical insurance system provides a safety net. A year of dialysis may cost you less than what used to be one year’s salary.

The Kidney: A Silent Overachiever

To understand why young people develop uremia, you first need to understand how the kidneys work.

Your kidneys are the body’s “wastewater treatment plant,” but they have a deeply counterintuitive characteristic: an extraordinarily strong ability to compensate.

Even when only 30% of your kidney units are still functioning, you may feel that everything is perfectly normal.

By the time the kidneys completely stop working, more than 85% of their function has often already been lost. Medically, this is known as end-stage kidney disease, commonly referred to as uremia.

Here are three stories that show how young people end up putting themselves in the dialysis room.

Story One: A 21-Year-Old Woman Ignored One Checkup—and Developed Uremia

A young woman from Zhejiang was found to have protein in her urine during a medical examination several years ago.

The doctor told her to return for further testing, but because she felt no pain or discomfort, she ignored it.

Then one day, she lost her appetite, her face became swollen, and she developed nausea and vomiting. She was rushed to the emergency room.

Her blood pressure was alarmingly high, and her serum creatinine level was 40 times the normal value. She was immediately diagnosed with uremia.

The kidneys had sounded their final alarm—but she had dismissed it as background noise.

Story Two: A 34-Year-Old Programmer—Late Nights, Obesity, and a Coma

Xiaofeng, a programmer under 175 centimeters tall, gained weight rapidly during two years of working from home, eventually reaching 200 jin—about 100 kilograms.

He regularly stayed awake at night and slept during the day.

One day, his mother called him three times to come and eat lunch, but he did not respond. When she opened the door, she found him unconscious on the bed.

At the hospital, doctors diagnosed him with a severe infection, kidney failure, heart failure, uremic encephalopathy, and an acute ischemic stroke. His serum creatinine level was more than ten times the normal limit.

His life was saved, but he will have to depend on hemodialysis for the rest of his life.

Story Three: A 25-Year-Old Man Let High Blood Pressure Progress to Uremia in Nine Months

At the end of last year, Xiao Liu was hospitalized because of severe dizziness.

His blood pressure was 210/120 mmHg, his urine tested positive for protein, and his serum creatinine level was 195 μmol/L, compared with a normal range of 53–115 μmol/L.

His doctor told him to start taking blood pressure medication immediately.

Although he took the medication, he thought, “I’m young. My body can handle it.” He continued staying up late playing video games and eating takeout at every meal.

Just nine months later, his serum creatinine had soared to 1,058 μmol/L. He had lost more than 90% of his kidney function.

There was no escaping the diagnosis: uremia.

The Three Main Paths to Uremia Among Young People

These three stories represent the three most common routes:

Ignoring medical checkups → minor problems become serious diseases
Late nights + obesity + takeout food → metabolic syndrome destroys the kidneys
Ignoring hypertension or diabetes → glomerulosclerosis

Why Are Young People Developing Uremia “Now”?

The kidneys have not evolved. Young people’s lifestyles have collectively changed.

Chronic Diseases Are Affecting Younger People

Diabetes, hypertension, high uric acid levels, and obesity were once considered diseases of middle-aged and elderly people. Today, they are no longer uncommon among university students.

Diabetic kidney disease is the leading cause of uremia in China.

When the upstream diseases affect younger people, the downstream consequence—uremia—naturally does the same.

Sugary Drinks Are Replacing Water

Many people drink milk tea and carbonated beverages as if they were water.

Fructose metabolism can contribute to high uric acid and high purine levels, directly harming the kidneys.

One young man nicknamed “Cola Bro” drank two or three bottles of cola every day. By age 24, he had developed late-stage uremia.

Takeout Food, Late Nights, and Holding in Urine: The Complete Package

Takeout food is often high in salt, sugar, and fat, increasing pressure on blood flow through the kidneys.

Staying up late prevents the kidneys from recovering properly at night.

Holding in urine causes urinary retention and can lead to ascending infections and pyelonephritis.

Medication Abuse

Some people casually swallow painkillers whenever they have a headache or fever.

Others trust unlicensed “kidney-tonifying remedies” or “miracle herbs.”

These substances can have toxic effects on the kidney tubules.

Most Importantly: Poor Health Awareness

Young people often believe their bodies can “take the punishment.”

But with the kidneys, by the time you feel that something is wrong, it is often already too late.

The Chinese Context

In China, developing uremia does not necessarily mean the end of your life.

What does that mean?

Twenty years ago, if a young person from a rural family in China developed uremia, they would often have had no choice but to abandon treatment and wait for death.

Today, a young person with the disease may pay only a few thousand yuan out of pocket for an entire year of dialysis—and may still be able to continue working, get married, and have children.

That is the power of a major national medical insurance system, and there is no need to shy away from acknowledging it.

Practical Advice

Get Two Essential Kidney Tests Every Year

Make sure your annual medical checkup includes:

Routine urinalysis + urine albumin-to-creatinine ratio
Serum creatinine + estimated glomerular filtration rate (eGFR)

These tests cost only a few dozen yuan and may detect kidney damage three to five years in advance.

Do Not Ignore High Blood Pressure or Blood Sugar

If hypertension and diabetes are properly controlled with standardized medication, kidney function can often be preserved.

The belief that “I’m young, so my body can handle it” is one of the things young patients in dialysis centers regret most.

Beverages Are Not Water

Drink 1,500–2,000 milliliters of water per day.

Milk tea and other sugary drinks should be treated as snacks, not as water.

Limit Salt in Takeout Food

Consume less than 5 grams of salt per day.

Try not to eat heavily seasoned takeout food more than three times a week.

Do Not Misuse Painkillers

Do not take painkillers such as ibuprofen continuously for more than three days without medical guidance.

If you need to take painkillers long-term, consult a doctor.

Do Not Hold in Urine

Holding in urine really can contribute to urinary infections and pyelonephritis.